The Centers for Medicare & Medicaid Services (CMS) Medicaid managed care regulations at 42 C.F.R. § 438 govern how states may direct plan expenditures in connection with implementing delivery system and provider payment initiatives under Medicaid managed care contracts. CMS began reviews of state directed payment arrangements beginning with contract rating periods on or after July 1, 2017. For more information on state directed payments, please visit our Guidance Page. Persons with disabilities having problems accessing the Preprint PDF files may call 410-786-0429 for assistance.
Approved State Directed Payment Preprints
Results
Displaying 1 - 10 of 677
SDP Identifier:: LA_Fee_BHO3_Renewal_20240701-20250630
State: Louisiana
Summary:
A uniform dollar increase for psychotherapy services that utilize dialectical behavior therapy (DBT) for behavioral health outpatient services for the rating period covering July 1, 2024 through June 30, 2025, incorporated in the capitation rates through a separate payment term of up to $3,268,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Behavioral health outpatient services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: LA_Fee_BHO2_Renewal_20250101-20251231
State: Louisiana
Summary:
A uniform dollar increase for psychotherapy services that utilize dialectical behavior therapy (DBT) for behavioral health outpatient services for the rating period covering January 1, 2025 through December 31, 2025, incorporated in the capitation rates through a separate payment term of up to $172,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Behavioral health outpatient services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: AZ_Fee_IPH.OPH1_Renewal_20241001-20250930
State: Arizona
Summary:
Uniform increase for inpatient and outpatient hospital services at freestanding children’s hospitals with more than 100 licensed pediatric beds for the rating period covering October 1, 2024 through September 30, 2025, and incorporated in the capitation rates through a separate payment term of up to $59,120,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service, Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: WI_Fee_Oth_Renewal_20250101-20251231
State: Wisconsin
Summary:
Minimum and maximum fee schedules established by the state for the rating period, January 1, 2025 through December 31, 2025, incorporated into the capitation rates through a risk-based rate adjustment.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Other
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: LA_Fee_BHO_Renewal_20240701-20250630
State: Louisiana
Summary:
Uniform increase for licensed mental health providers, and certain provisionally licensed mental health providers, who perform specific services for the rating period covering July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term up to $18,400,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Behavioral health outpatient services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: PR_Fee_D_Renewal_20241001-20250930
State: Puerto Rico
Summary:
Minimum fee schedule established by the state for dental services for the rating period, October 1, 2024 through September 30, 2025, incorporated into the capitation rates through a risk-based rate adjustment.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Dental services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: KS_Fee_IPH.OPH2_Amend_20240101-20241231
State: Kansas
Summary:
Uniform percentage increase for inpatient and outpatient hospital services provided by eligible general hospitals, for the rating period covering January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a separate payment term of up to $41,000,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service, Outpatient hospital service
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: TN_Fee_Oth1_Renewal_20250101-20251231
State: Tennessee
Summary:
Uniform dollar increase established by the state for emergency ground ambulance services for the rating period, January 1, 2025 through December 31, 2025, incorporated into the capitation rates through a separate payment term up to $36,579,920.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Other
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: PA_VBP_NF2_Amend_20230101-20231231
State: Pennsylvania
Summary:
Value-based purchasing established by the state for eligible nursing facility services for the rating period, January 1, 2023 through December 31, 2023, incorporated into the capitation rates through a separate payment term up to $15,000,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Nursing facility services
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: MA_Fee_IPH.OPH4_New_20230101-20231231
State: Massachusetts
Summary:
Uniform increase established by the state for eligible inpatient hospital services for the rating period covering January 1, 2023 through December 31, 2023, incorporated into the capitation rates for the Managed Behavioral Health Vendor through a separate payment term of up to $4,601,248.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service, Outpatient hospital service
Review Type: New
Approval Period: Single Rating Period
Results per page